A recent report from the Office of the National Coordinator (ONC) shows that e-prescribing among Physicians has skyrocketed since the eRx incentive of 2008, the EPCS (electronic prescriptions for controlled substances) interim rule of 2010 and the EHR incentive of 2011. As of April 2014, 70 percent of Physicians are now prescribing through their EHRs and 96 percent of community pharmacies across the U.S. are now able to accept e-prescriptions. This represents a 50 percent increase since 2011 for Physicians in most states and a 20 percent increase for pharmacies since 2008.
Proponents have long been advocating for the benefits of e-prescribing – specifically, the potential to enhance patient safety, reduce drug costs, increase access to patient prescription records and improve pharmacy workflow.
Adverse drug events (ADE) have been shown to decrease with the use of e-prescribing software, which alerts providers of potential prescription errors, prompts providers to verify medication allergies, confirm dosage and identify drug interactions prior to transmission. A one-year study of over 26,000 e-prescriptions showed an average reduced cost of $4.12 per prescription. E-prescribing has also been shown to streamline prescription processing, reduce wait times and encourage pharmacy consultations – all of which can lead to greater patient satisfaction and prescription adherence.
E-prescribing isn’t without pitfalls, however. While e-prescribing can eliminate certain errors, the potential for new errors – and “same old” errors – still exists. This is especially true for omitted or inaccurate icenformation, such as the omission of prescriber NPI and/or DEA credentials (which are critical for EPCS), but can also manifest as wrong patient selection and incorrect directions. One study showed that e-prescriptions require about five minutes more interaction between Pharmacists and prescribers per prescription because of missing or inaccurate information that would violate legal requirements and lead to fines if dispensed without validation. Many pharmacies are using a prescriber validation service like HDS’ PVSS solution to avoid these problems.
Software design issues – such as clunky drop-down menus, poor screen designs and automatic refill functions – also have the potential to cause workflow challenges and time-consuming manual functions to resolve information gaps and errors. System errors and incompatibilities and lack of training among pharmacy personnel can exacerbate these problems and create additional workflow inefficiencies.
As e-prescribing through EHRs evolves, it is clear that EHR developers will need to address these system issues to meet the growing needs of pharmacies and prescribers, who are subject to considerable fines – and imprisonment, in some cases. HDS’ latest whitepaper, “How EHRs Can Become More Than Just Vendors” suggests the next steps necessary to ensure that e-prescribing reaches the potential it has to benefit providers, pharmacies and patients.
